Alcoholism is a major public health problem for which there is no known cure. Depression frequently occurs concomitantly with alcoholism and has been strongly associated with relapsed drinking in alcoholics striving to maintain sobriety. Treatment with tricyclic antidepressant medications (TCA) might reverse either depressive symptomotology associated with relapsed drinking, or biochemical abnormalities hypothesized to underly alcoholism and depression. Thus, by these or other mechanisms, TCA's may provide a powerful aid to continued abstinence in recovering alcoholics. Recent investigations of the biotransformation of amitriptyline, imipramine and desipramine in alcoholics suggest that higher than usual doses of TCA's may be required for drug plasma concentrations to reach a standard range. No prior study of TCA treatment of alcoholics has measured drug plasma concentrations in order to insure adequate dosage and compliance, nor examined both sobriety and depressive symptomatology as outcome measures. The current study will be a double blind, random assignment comparison of desipramine (DMI) and placebo, to test the efficacy of DMI in maintaining abstinence in detoxified patients with primary Alcohol abuse or Dependence. Subjects will be matched for gender and presence or absence of secondary depression, because significant sex differences have been reported for the rate of secondary depression in alcoholics, and for the familial incidence of alcoholism, and these variables may particularly relate to outcome in an antidepressant study. Plasma DMI will be measured monthly in order to insure adequate dosage and compliance. Treatment will be of 6 months duration. The following specific hypotheses will be tested in the study: 1) Patients treated with an adequate dose of DMI will have a significantly higher rate of abstinence at 6 months than patients treated with placebo; and 2) Depressive symptomatology in alcoholics will be reduced by adequate dosage of DMI significantly more than by placebo. Other explanatory aims of this study will be to: a) gather descriptive data pertinent to a more thorough and systematic classification of alcoholics; b) generate hypotheses about which clinical and demographic variables predict abstinence or drinking in a TCA-treated sample and c) study sequential relationships between drinking and depression in detoxified alcoholics. Subgroups of alcoholics particularly responsive to TCA treatment may be identified, and studied specifically in a follow up protocol, to clarify the risk of relapse vs. the cost and risk of prolonged chemotherapy.